Ahmadi Naser, Hajsadeghi Fereshteh, Gul Khawar, Vane Jackson, Usman Nudrat, Flores Ferdinand, Nasir Khurram, Hecht Harvey, Naghavi Morteza, Budoff Matthew
Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 West Carson Street, RB2, Torrance, CA 90502, USA.
J Cardiovasc Comput Tomogr. 2008 Nov;2(6):382-8. doi: 10.1016/j.jcct.2008.09.001. Epub 2008 Sep 26.
Digital thermal monitoring (DTM) of vascular function was shown to correlate with the presence of known coronary artery disease (CAD).
We evaluated whether DTM can identify at-risk, asymptomatic patients with significant coronary artery calcium (CAC) or increased Framingham risk score (FRS).
Two hundred thirty-three consecutive asymptomatic subjects (58 +/- 11 years; 62% men) without known CAD underwent DTM, CAC, and FRS calculation. DTM measurements were obtained during and after a 5-minute suprasystolic arm-cuff occlusion. After cuff-deflation temperature rebound (TR) and area under the temperature curve (AUC) were measured and correlated with FRS and CAC.
TR was lower in patients with FRS > 20% and CAC >or= 100 as compared with FRS < 10% and CAC < 10, respectively (P < 0.05). After adjustment for age, sex, and traditional cardiac risk factors, the odds ratio of the lowest compared with the upper 2 tertiles of TR was 3.96 for FRS >or= 20% and 2.37 for CAC >or= 100 compared with low-risk cohorts. The area under the receiver operating characteristic (ROC) curve to predict CAC >or= 100 increased significantly from 0.66 for FRS to 0.79 for TR to 0.89 for TR + FRS.
Vascular dysfunction measured by DTM strongly correlates with FRS and CAC independent of age, sex, and traditional cardiac risk factors and was superior to FRS for the prediction of significant CAC.
血管功能的数字热监测（DTM）已被证明与已知冠状动脉疾病（CAD）的存在相关。
我们评估DTM是否能够识别有显著冠状动脉钙化（CAC）或弗明汉风险评分（FRS）升高的高危无症状患者。
233例连续的无症状受试者（年龄58±11岁；62%为男性），无已知CAD，接受了DTM、CAC测量及FRS计算。DTM测量在5分钟的收缩期上臂袖带闭塞期间及之后进行。袖带放气后，测量温度反弹（TR）和温度曲线下面积（AUC），并将其与FRS和CAC进行关联。
与FRS<10%和CAC<10的患者相比，FRS>20%和CAC≥100的患者TR较低（P<0.05）。在对年龄、性别和传统心脏危险因素进行调整后，与低风险队列相比，TR最低三分位数与最高三分位数相比，FRS≥20%时的比值比为3.96，CAC≥100时为2.37。预测CAC≥100的受试者操作特征（ROC）曲线下面积从FRS的0.66显著增加到TR的0.79，再到TR+FRS的0.89。
通过DTM测量的血管功能障碍与FRS和CAC密切相关，独立于年龄、性别和传统心脏危险因素，并且在预测显著CAC方面优于FRS。
